Title Page
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Date for when the Inspections were carried out.
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Site where the inspection was carried out.
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Prepared by
INSPECTION INFORMATION
- USER INFORMATION
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Name of User
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Harness Manufacturer
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Harness - Date of Manufacture - (D.O.M).
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Harness Serial Number
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Have any defects been found whilst inspecting the harness?
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Is the Harness Fit for Purpose?
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Has the Harness been taken out of service?
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Lanyard Manufacturer
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Lanyard Serial Number
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Lanyard - Date of Manufacture - (D.O.M).
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Have any defects been found whilst inspecting the lanyards?
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Is the Lanyard Fit for Purpose?
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Has the Lanyard been taken out of service?
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Inspectors name & Signature
